Thomas DeLuca 12/31/2010m '.'~L~!.,r,IBEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.aov
OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk
Tel: (305) 673-741 1, Fax: (305) 673-7254
01 /16/2009
Thomas DeLuca
1662 Lincoln Ct. #307
Miami Beach, Florida 33139
SUBJECT: Design Review Board
Congratulations! You have been reappointed by the City Commission to the above
referenced agency, board or committee for a term ending: 12131/2010.
If you are unable to accept this appointment, please notify the City Clerk's Office at
(305) 673-7411.
Please read the enclosed material carefully. Again, congratulations and good luck.
Sincerely,
~~~~
obert Parcher
City Clerk
cc: Saul Frances, Parking Director
Thomas Mooney
ATTACHMENTS:
Letter of Appointment
Oath
City Code Ordinance section, applicable to agency, board or committee
City Code Section 2-22, 2-23, 2-24, 2-25, 2-26, 2-2458, 2-459
Ordinance 2006-3543 -Amendment to City Code Section 2-22
Miami-Dade County Code Section 2-11.1 -Conflict of Interest and Code of Ethics Ordinance
City Wide Permit Application - (Parking Department Form)
Booklet -Guide to the Sunshine Amendment and Code of Ethics for Public Officers and
Employees
We are committed to providing excellent public service and safety to all who live, work and play in our vibrant, tropical, historic community.
m 11AMIBEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.aov
OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk
Tel: X305) 673-741 1, Fax: (305J 673-7254
TO Thomas DeLuca
RE: Design Review Board
I do solemnly swear or affirm to bear true faith, loyalty and allegiance to the Government of the
United States, the State of Florida, and the City of Miami Beach, and to perform all the duties of
a member of the above-mentioned board or committee of the City of Miami Beach to which I have
been appointed for a term ending: 12/31/2010.
I have been issued a copy of Section 2-11.1 of the Miami-Dade County Code (Conflict of Interest
and Code of Ethics Ordinance), as well as theF/orida Commission on Ethics Guide to the Sunshine
Amendment and Code of Ethics for Public Officers and Employees, and understand that as a member
of a City of Miami Beach Board and/or Committee, I must comply with the financial disclosure* require-
ments of Miami-Dade County or the State of Florida (depending on the board or committee on which
I serve) on July 1st, following the closing of the calendar year on ich I have served.
I
` - --
e ~
omas DeLuca
Sworn to and subscribed before me this~Z', day of ~ ~ 200~:~
_.
'~~~ E.
Kerry Hernandez
Deputy Clerk
*Please visit the City of Miami Beach website at www.miamibeachfl.gov under City Clerk/Board and Committees
for additional information regarding the Financial Disclosure Requirements.
We are committed to providing excellent public service and safety to all who live, work and play in our vibrant, tropical, historic community.
1 V l E ~~~~ ~ ~"~t CI T Y F 3~~IIAII~€ B~~R~t-f
~~3~,RC~ AND ~QMt~IlT T EE APPiwIC~TIt"3P~ F4JR6`Ji
NAME: ~~~~-_ L U (~.~ ---~j~~~~
Last Name First Name Middle Initial
HOME ADDRESS: ~ 101 Z- L) T~ G C-t--~1 G. (1 U ~T '~ 3~>Tl M 1~-~M) TS~~~ ~ ~L -~513~
No. Street City State Zip Code
PHONE: 3 ~'~ ~Q'~L ~ ~~ ~ ~ .~~~L ~~ `'~~Cit~ •CG>/1
Home Work Fax Email address
Business Name: ~ t'i) G a 1''1 M (.9N -~ ~-h~7jbl.._
Address: ~ '~ C_l.~ i7Q~~L, )~LV n . ~~~ ~ ~-'~
Position: Y' ~' ~ ~~ 11~1E~. ~N K.- 5~
~Ci x~.~ ~L 3~~ ~
No. Street City State Zip Code
Professional License (describe) .~`3--ti~~~~ Expire~(1 ~~ Attach a cagy of tha ttccnse
Pursuant to City Code section 2-22(4) a and b: Members of agencies, boards, and committees shall be affiliated with the city; this
requirement shall be fulfilled in the following ways: a) an individual shall have been a resident of the city for a minimum of six
months; or b) an individual shall demonstrate ownership/interest for a minimum of six months in a business established in the city.
• Resident of Miami Beach for a minimum of six (ti) months: Yes~or No ^
• Demonstrate an ownership/interest in a business in Miami Beach for a minimum of six (ti) months: Yes ^ or No~
• Are you a registered voter in Miami Beach: Yes~or No ^
• (Please circle one): I am now a resident of: North Beach th Beac \ Middle Beach
• I am applying for an appointment because I have special abilities, knowledge, experience. Please list below:
riease ust your preferences in order of ranking [1] first choice [2] second choice, and [3] third choice. Please note that only three (3)
choices will be observed by the Citv Clerk's Office (Regular Boards of City)
^ Affordable Housin Adviso Committee ^ Historic Preservation Board*
^ Art in Public Places Committee ^Housin Authori *
^ Beach Preservation Board ^ Loan Review Committee*
^ Beautification Committee ^ Marine Authori *
^ Board of Ad~ustment* ^ Miami Beach Commission for Women
^ Bud et Adviso Committee ^ Miami Beach Cultural Arts Council
^ Ca ital Im rovements Pro'ects Oversi ht Committee ^ Miami Beach Sister Cities Pro ram
^ Committee on the Homeless ^ Normand Shores Local Gov't Nei h. Im rovement
^ Committee for Qualit Education in MB ^ Parks and Recreation Facilities Board
^ Communit Develo ment Adviso ^ Personnel Board*
^ Communi Relations Board ^ Plannin Board
^ Convention Center Adviso Board ^ Police Citizens Relations Committee
^ Cultural Arts Nei hborhood District Overla CANDO ^ Production Indust Council
^ Debarment Committee ^ Public Safet Adviso Committee
esi n Review Board* ^ Safet Committee
^ Disabilit Access Committee ^ Single Famil Residential Review Panel
^ Fine Arts Board ^ Sustainabilit Committee
^ Ga Business Develo ment Ad Hoc ^ Trans arenc Reliabilit & Accountabilit Committee "TRAC"
^ Golf Adviso Committee ^ Trans ortation and Parkin Committee
^ Health Adviso Committee ^ Visitor and Convention Authorit *
^ Health Facilities Authorit Board ^ Youth Center Adviso Board
^ His anic Affairs Committee
G5(`1 ~cr,cni ~ * Board Required to File State Disclosure form
~,-~~~~~~.~~~~~~va~u a ~omn~ittees;rsc~c; ApplicationiB&C Application Revicry~,c, 111303 2.cloc
Note: If applying for Youth Advisory Board, please indicate your affiliation with the Scott Rakow Youth Center:
1. Past service on the Youth Center Advisory Board: Yes ^ No ^ Years of Service:
2. Present participation in Youth Center activities by your children Yes^ No ^. If yes, please list the names of your children, their
ages, and which programs. List below:
Child's name: Age: Program:
Child's name: Age: Program:
.Have you ever been convicted of a felony: Yes ^ or No~~lf yes, please explain in detail:
• Do you currently have a violation(s) of City of Miami Beach codes: Yes ^ or N~ If yes, please explain in detail:
• Do you currently owe the City of Miami Beach any money: Yes ^ or N~ If yes, explain in detail
• Are you currently serving on any City Boards or Committees: lt,or No ^. If yes; which board?
• What organizations in the City of Miami Beach do you currently hold membership in?
Name:
Title:
Name:
• List all properties owned or have an interest in, which are located within the City of Miami Beach:
• I am now employed by the City of Miami Beach: Yes ^ or N$t~Which department
• Pursuant to City Code Section 2-25 (b): Do you have a parent ^, spouse ^, child ^, brother ^, or sister ^ who is employed by the
City of Miami Beach? Check all that apply. Identify the department(s):
This section is "not required" but desired: Aqe~ years old Gender. Male ^ Female ^
Race: Whlte ^ African-American/Black ^ White/Hispanic: ^ Asian or Pacific Islander ^ American Indian or
Alaskan Native ^ Haitian: ^ Origin Ethnic: Hispanic: Yes or No
"I hereby attest to the accuracy and truthfulness of the application and have received, read and will abide by Chapter 2,
Article VII - of the City Code "Standards of Conduct for City Officers, Employees and Agency Members."
-- ~~' ~ z
Applicant's ignature Date
PRINT)
Please attach a copy of your resume to this application
NOTE: Applications will remain on file for a, period of one (1) calendar year.
Employment Status: Employed ^ Retired ^ Home-maker ^ Other ^
Received in City Clerk's Office by
~>h~ ~s ~ ~, ~ c~
Name of Applicant (PLEASE
Name of Deputy Clerk L
Document Control Number (Assigned by the City Clerk's Office) ~`"' ~ Entered
F:'~~CLER`:SALL!Board & Committeesl3~r~ ApplicationlB&C Application Revi:2~d 11 130; 2doc